2.

Evaluation month:
G June
3.Communications
G Explains medical dosimetry procedures to patient as appropriate to situation. - N/A
G Respects patient's rights to privacy and confidentiality. - Meets Expectations[3 pts]
G Acts and speaks in a respectful manner with staff members. - Partially Meets Expectations(Additional
Comment: She needs to get more at ease with her role in the department.)[2 pts]
G Asks questions in an appropriate manner. - Meets Expectations[3 pts]
G Accepts correction and direction in a professional manner. - Meets Expectations[3 pts]
G Contributes as a member of the medical dosimetry team. - Meets Expectations[3 pts]
G Uses effective verbal communication skills with physician during plan consultation and review. - Meets
Expectations[3 pts]
G Uses effective written communication skills for chart, plan, and dosimetry note documentation. - Meets
Expectations[3 pts]
MEAN: 2.86 (out of possible 3), % SCORE: 95.2%
4.Accuracy
G Performs dose calculations accurately. - Meets Expectations[3 pts]
G Reads radiation measurement devices accurately and carefully. (eg, TLD, Diodes. Film, Ion Chamber) - N/A
G Accurately designs plans by computer or manual computation in accordance with prescription. - Meets
Expectations[3 pts]
G Accurately enters information into chart or R & V system. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
Individual Responses Detail - "Clinical Affective Evaluation"
(Filters currently ON)
Evaluation Period from: 5/27/2014
Evaluation Period through: 8/31/2014
Evaluations Completed from: 5/27/2014
Evaluations Completed through: 8/31/2014
Evaluations for: Tlougan, Heather

Filtered Responses: 4
TOTAL RESPONSES: 218
Evaluation by: Clinical Instructors (WEIS, Mark)
Evaluation of: Students (Tlougan, Heather)
Evaluation Period: 6/18/2014
Survey Completed: 7/15/2014 9:16:48 AM CT
Last viewed by Tlougan, Heather: 8/1/2014 11:52:46 AM CT
5.Safety
G Takes appropriate precautions in Radiation Safety. - Meets Expectations[3 pts]
G Double checks all calculations and treatment plans with dosimetrist/physicist. - Meets Expectations[3 pts]
G Performs Quality Assurance per recommended guidelines and reviews with dosimetrist/physicist. - Meets
Expectations[3 pts]
G Uses time, distance, shielding practices & principles. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
6.Dependability
G Arrives promptly as scheduled. - Meets Expectations[3 pts]
G Schedules breaks, lunches, and other time needs with clinical instructors. - Meets Expectations[3 pts]
G Adheres to attendance standards of the program. - Meets Expectations[3 pts]
G Uses clinical time wisely. - Meets Expectations[3 pts]
G Follows school and hospital policies and procedures. - Meets Expectations[3 pts]
G Takes initiative in observing and assisting in dosimetry activities. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
7.Application of Knowledge
G Understands the technique and use of special calculation methods. - N/A
G Is able to retrieve imaging study (CT) and bring into patient file. - Meets Expectations[3 pts]
G Is able to identify anatomy and contour appropriate structures. - Meets Expectations[3 pts]
G Understands the use of the computer for treatment planning. - Meets Expectations[3 pts]
G Is able to enter information into the computer and design treatment plan in accordance with prescription. -
Meets Expectations[3 pts]
G Utilizes critical thinking/problem solving skills in approaching treatment planning. - Meets Expectations[3
pts]
G Demonstrates a basic understanding of physics concepts and principles. - Meets Expectations[3 pts]
G Understands how clinical oncology information is used in treatment planning. - Meets Expectations[3 pts]
G Utilizes critical thinking skills when evaluating dose volume histograms. - Meets Expectations[3 pts]
G Uses problem solving skills when comparing various treatment plans for a specific treatment case. - Meets
Expectations[3 pts]
G Is able to design optimal treatment plans based on calculations, dose volume histograms, prescription, and
treatment implementation. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
8.General Dosimetry Skills
G Performs calculations in a timely manner. - Meets Expectations[3 pts]
G Accurately uses dose calculation databooks to perform hand calculations. - Meets Expectations[3 pts]
G Is able to dose out chart per prescription and plan. - Meets Expectations[3 pts]
G Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical field arrangement. -
Meets Expectations[3 pts]
G Is able to independently produce treatment plans as required by competency list for the semester. - Meets
Expectations[3 pts]
G Is able to prioritize and organize duties to efficiently complete requirements. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
9.I have reviewed this evaluation with the student.
G No(Additional Comment: She was only here for one week that month. Since she isn't here atm I can't talk to
her about this evaluation.)
10.Additional Comments:
G No response
Mean percentage score for all rating scale questions: 99.2%
(Each main question equally weighted)
Responses as of 9/9/2014 7:03:50 PM CT

2.
Evaluation month:
G June 2014 This eval is for the 1st 3 weeks at the VA
3.Communications
G Explains medical dosimetry procedures to patient as appropriate to situation. - N/A
G Respects patient's rights to privacy and confidentiality. - Meets Expectations[3 pts]
G Acts and speaks in a respectful manner with staff members. - Partially Meets Expectations(Additional
Comment: Brings personal struggles to clinical site)[2 pts]
G Asks questions in an appropriate manner. - Meets Expectations[3 pts]
G Accepts correction and direction in a professional manner. - Partially Meets Expectations(Additional
Comment: Difficult Time following instruction and direction)[2 pts]
G Contributes as a member of the medical dosimetry team. - Does Not Meet Expectations(Additional
Comment: underperforming in most arreas of planning process)[1 pts]
G Uses effective verbal communication skills with physician during plan consultation and review. - N/A
G Uses effective written communication skills for chart, plan, and dosimetry note documentation. - Meets
Expectations[3 pts]
MEAN: 2.33 (out of possible 3), % SCORE: 77.8%
4.Accuracy
G Performs dose calculations accurately. - Meets Expectations[3 pts]
G Reads radiation measurement devices accurately and carefully. (eg, TLD, Diodes. Film, Ion Chamber) - N/A
G Accurately designs plans by computer or manual computation in accordance with prescription. - Does Not
Meet Expectations[1 pts]
G Accurately enters information into chart or R & V system. - Meets Expectations[3 pts]
MEAN: 2.33 (out of possible 3), % SCORE: 77.8%
5.Safety
G Takes appropriate precautions in Radiation Safety. - Meets Expectations[3 pts]
G Double checks all calculations and treatment plans with dosimetrist/physicist. - Meets Expectations[3 pts]
G Performs Quality Assurance per recommended guidelines and reviews with dosimetrist/physicist. - Meets
Expectations[3 pts]
G Uses time, distance, shielding practices & principles. - Meets Expectations[3 pts]
Evaluation by: Clinical Instructors (SCHMITZ, James)
Evaluation of: Students (Tlougan, Heather)
Evaluation Period: 6/30/2014
Survey Completed: 7/16/2014 2:25:17 PM CT
Last viewed by Tlougan, Heather: 8/5/2014 2:20:43 PM CT
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
6.Dependability
G Arrives promptly as scheduled. - Does Not Meet Expectations[1 pts]
G Schedules breaks, lunches, and other time needs with clinical instructors. - Meets Expectations[3 pts]
G Adheres to attendance standards of the program. - Does Not Meet Expectations[1 pts]
G Uses clinical time wisely. - Partially Meets Expectations[2 pts]
G Follows school and hospital policies and procedures. - Partially Meets Expectations[2 pts]
G Takes initiative in observing and assisting in dosimetry activities. - Partially Meets Expectations[2 pts]
MEAN: 1.83 (out of possible 3), % SCORE: 61.1%
7.Application of Knowledge
G Understands the technique and use of special calculation methods. - Partially Meets Expectations[2 pts]
G Is able to retrieve imaging study (CT) and bring into patient file. - Partially Meets Expectations[2 pts]
G Is able to identify anatomy and contour appropriate structures. - Meets Expectations[3 pts]
G Understands the use of the computer for treatment planning. - Meets Expectations[3 pts]
G Is able to enter information into the computer and design treatment plan in accordance with prescription. -
Partially Meets Expectations[2 pts]
G Utilizes critical thinking/problem solving skills in approaching treatment planning. - Does Not Meet
Expectations[1 pts]
G Demonstrates a basic understanding of physics concepts and principles. - Meets Expectations[3 pts]
G Understands how clinical oncology information is used in treatment planning. - Meets Expectations[3 pts]
G Utilizes critical thinking skills when evaluating dose volume histograms. - Partially Meets Expectations[2 pts]
G Uses problem solving skills when comparing various treatment plans for a specific treatment case. - Partially
Meets Expectations[2 pts]
G Is able to design optimal treatment plans based on calculations, dose volume histograms, prescription, and
treatment implementation. - Does Not Meet Expectations[1 pts]
MEAN: 2.18 (out of possible 3), % SCORE: 72.7%
8.General Dosimetry Skills
G Performs calculations in a timely manner. - Meets Expectations[3 pts]
G Accurately uses dose calculation databooks to perform hand calculations. - Meets Expectations[3 pts]
G Is able to dose out chart per prescription and plan. - N/A
G Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical field arrangement. -
Meets Expectations[3 pts]
G Is able to independently produce treatment plans as required by competency list for the semester. - Does Not
Meet Expectations[1 pts]
G Is able to prioritize and organize duties to efficiently complete requirements. - Does Not Meet
Expectations[1 pts]
MEAN: 2.20 (out of possible 3), % SCORE: 73.3%
9.I have reviewed this evaluation with the student.
G Yes
10.Additional Comments:
G Heather struggled with the transition to the VA. We attempted to simplify her time here by having her work
with only one Dosimetrist but I fell she is underperforming in many areas. Jim Schmitz
Mean percentage score for all rating scale questions: 77.1%
(Each main question equally weighted)
Responses as of 9/9/2014 7:03:50 PM CT

2.
Evaluation month:
G July
3.Communications
G Explains medical dosimetry procedures to patient as appropriate to situation. - Meets Expectations[3 pts]
G Respects patient's rights to privacy and confidentiality. - Meets Expectations[3 pts]
G Acts and speaks in a respectful manner with staff members. - Meets Expectations[3 pts]
G Asks questions in an appropriate manner. - Partially Meets Expectations(Additional Comment: Still
interrupts frequently. We are working on this.)[2 pts]
G Accepts correction and direction in a professional manner. - Partially Meets Expectations(Additional
Comment: Gets defensive easily.)[2 pts]
G Contributes as a member of the medical dosimetry team. - Meets Expectations[3 pts]
G Uses effective verbal communication skills with physician during plan consultation and review. - Meets
Expectations[3 pts]
G Uses effective written communication skills for chart, plan, and dosimetry note documentation. - Meets
Expectations[3 pts]
MEAN: 2.75 (out of possible 3), % SCORE: 91.7%
4.Accuracy
G Performs dose calculations accurately. - Meets Expectations[3 pts]
G Reads radiation measurement devices accurately and carefully. (eg, TLD, Diodes. Film, Ion Chamber) - N/A
G Accurately designs plans by computer or manual computation in accordance with prescription. - Meets
Expectations[3 pts]
G Accurately enters information into chart or R & V system. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
5.Safety
G Takes appropriate precautions in Radiation Safety. - Meets Expectations[3 pts]
G Double checks all calculations and treatment plans with dosimetrist/physicist. - Meets Expectations[3 pts]
G Performs Quality Assurance per recommended guidelines and reviews with dosimetrist/physicist. - Meets
Expectations[3 pts]
G Uses time, distance, shielding practices & principles. - Meets Expectations[3 pts]
Evaluation by: Clinical Instructors (WEIS, Mark)
Evaluation of: Students (Tlougan, Heather)
Evaluation Period: 7/29/2014
Survey Completed: 8/1/2014 11:42:50 AM CT
Last viewed by Tlougan, Heather: 8/5/2014 2:20:44 PM CT
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
6.Dependability
G Arrives promptly as scheduled. - Meets Expectations[3 pts]
G Schedules breaks, lunches, and other time needs with clinical instructors. - Meets Expectations[3 pts]
G Adheres to attendance standards of the program. - Meets Expectations[3 pts]
G Uses clinical time wisely. - Meets Expectations[3 pts]
G Follows school and hospital policies and procedures. - Meets Expectations[3 pts]
G Takes initiative in observing and assisting in dosimetry activities. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
7.Application of Knowledge
G Understands the technique and use of special calculation methods. - Meets Expectations[3 pts]
G Is able to retrieve imaging study (CT) and bring into patient file. - Meets Expectations[3 pts]
G Is able to identify anatomy and contour appropriate structures. - Meets Expectations[3 pts]
G Understands the use of the computer for treatment planning. - Meets Expectations[3 pts]
G Is able to enter information into the computer and design treatment plan in accordance with prescription. -
Meets Expectations[3 pts]
G Utilizes critical thinking/problem solving skills in approaching treatment planning. - Partially Meets
Expectations[2 pts]
G Demonstrates a basic understanding of physics concepts and principles. - Meets Expectations[3 pts]
G Understands how clinical oncology information is used in treatment planning. - Meets Expectations[3 pts]
G Utilizes critical thinking skills when evaluating dose volume histograms. - Meets Expectations[3 pts]
G Uses problem solving skills when comparing various treatment plans for a specific treatment case. - Meets
Expectations[3 pts]
G Is able to design optimal treatment plans based on calculations, dose volume histograms, prescription, and
treatment implementation. - Meets Expectations[3 pts]
MEAN: 2.91 (out of possible 3), % SCORE: 97.0%
8.General Dosimetry Skills
G Performs calculations in a timely manner. - Meets Expectations[3 pts]
G Accurately uses dose calculation databooks to perform hand calculations. - Meets Expectations[3 pts]
G Is able to dose out chart per prescription and plan. - Meets Expectations[3 pts]
G Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical field arrangement. -
Meets Expectations[3 pts]
G Is able to independently produce treatment plans as required by competency list for the semester. - Meets
Expectations[3 pts]
G Is able to prioritize and organize duties to efficiently complete requirements. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
9.I have reviewed this evaluation with the student.
G Yes
10.Additional Comments:
G She is still working on her approach to problem solving plans.
Mean percentage score for all rating scale questions: 98.1%
(Each main question equally weighted)
Responses as of 9/9/2014 7:03:50 PM CT

2.
Evaluation month:
G August
3.Communications
G Explains medical dosimetry procedures to patient as appropriate to situation. - N/A
G Respects patient's rights to privacy and confidentiality. - Meets Expectations[3 pts]
G Acts and speaks in a respectful manner with staff members. - Meets Expectations[3 pts]
G Asks questions in an appropriate manner. - Meets Expectations[3 pts]
G Accepts correction and direction in a professional manner. - Meets Expectations[3 pts]
G Contributes as a member of the medical dosimetry team. - Meets Expectations[3 pts]
G Uses effective verbal communication skills with physician during plan consultation and review. - Meets
Expectations[3 pts]
G Uses effective written communication skills for chart, plan, and dosimetry note documentation. - Meets
Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
4.Accuracy
G Performs dose calculations accurately. - Meets Expectations[3 pts]
G Reads radiation measurement devices accurately and carefully. (eg, TLD, Diodes. Film, Ion Chamber) - N/A
G Accurately designs plans by computer or manual computation in accordance with prescription. - Meets
Expectations[3 pts]
G Accurately enters information into chart or R & V system. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
5.Safety
G Takes appropriate precautions in Radiation Safety. - Meets Expectations[3 pts]
G Double checks all calculations and treatment plans with dosimetrist/physicist. - Meets Expectations[3 pts]
G Performs Quality Assurance per recommended guidelines and reviews with dosimetrist/physicist. - Meets
Expectations[3 pts]
G Uses time, distance, shielding practices & principles. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
Evaluation by: Clinical Instructors (WEIS, Mark)
Evaluation of: Students (Tlougan, Heather)
Evaluation Period: 8/13/2014
Survey Completed: 8/13/2014 10:59:04 AM CT
Last viewed by Tlougan, Heather: 8/13/2014 11:29:33 AM CT
6.Dependability
G Arrives promptly as scheduled. - Meets Expectations[3 pts]
G Schedules breaks, lunches, and other time needs with clinical instructors. - Meets Expectations[3 pts]
G Adheres to attendance standards of the program. - Meets Expectations[3 pts]
G Uses clinical time wisely. - Meets Expectations[3 pts]
G Follows school and hospital policies and procedures. - Meets Expectations[3 pts]
G Takes initiative in observing and assisting in dosimetry activities. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
7.Application of Knowledge
G Understands the technique and use of special calculation methods. - N/A
G Is able to retrieve imaging study (CT) and bring into patient file. - Meets Expectations[3 pts]
G Is able to identify anatomy and contour appropriate structures. - Meets Expectations[3 pts]
G Understands the use of the computer for treatment planning. - Meets Expectations[3 pts]
G Is able to enter information into the computer and design treatment plan in accordance with prescription. -
Meets Expectations[3 pts]
G Utilizes critical thinking/problem solving skills in approaching treatment planning. - Meets Expectations[3
pts]
G Demonstrates a basic understanding of physics concepts and principles. - Meets Expectations[3 pts]
G Understands how clinical oncology information is used in treatment planning. - Meets Expectations[3 pts]
G Utilizes critical thinking skills when evaluating dose volume histograms. - Meets Expectations[3 pts]
G Uses problem solving skills when comparing various treatment plans for a specific treatment case. - Meets
Expectations[3 pts]
G Is able to design optimal treatment plans based on calculations, dose volume histograms, prescription, and
treatment implementation. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
8.General Dosimetry Skills
G Performs calculations in a timely manner. - Meets Expectations[3 pts]
G Accurately uses dose calculation databooks to perform hand calculations. - Meets Expectations[3 pts]
G Is able to dose out chart per prescription and plan. - Meets Expectations[3 pts]
G Exhibits knowledge of anatomy, tissue dose tolerance, definitive tumor dose, and typical field arrangement. -
Meets Expectations[3 pts]
G Is able to independently produce treatment plans as required by competency list for the semester. - Meets
Expectations[3 pts]
G Is able to prioritize and organize duties to efficiently complete requirements. - Meets Expectations[3 pts]
MEAN: 3.00 (out of possible 3), % SCORE: 100.0%
9.I have reviewed this evaluation with the student.
G Yes
10.Additional Comments:
G She has worked diligently over the last couple of weeks. I am a lot more comfortable with her approach and
she is less defensive. We have been working hard on getting 3D planning in order with the goal of getting test
outs done. Luckily we have had a bunch these last couple weeks. We have started familiarizing her with
IMRT and RA planning.
Mean percentage score for all rating scale questions: 100.0%
(Each main question equally weighted)
Responses as of 9/9/2014 7:03:50 PM CT